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Tag Archives: women’s health

Time and again it has been shown that women limit the size of their families in societies that sustain improved health, education and socio-economic vitality. Limiting family sizes is key to humanity reaching a sustainable population level and limiting human impact on the natural environment. Historically many women have turned to “the pill” for limiting of family sizes. More recently however, according to the Guttmacher Institute, there tends to be a trend in the increasing use of IUD among young women. Myself and my OB/Gyn colleagues are also seeing this trend in our own practices. They are drawn to the overall low cost, convenience of the method as well as the effectiveness. Still other women prefer to avoid the side effects that come along with birth control pills, like decreased libido, vaginal dryness and pain with sex, or breakthrough bleeding.

When it comes to the Copper IUD, otherwise know as the “Copper T” by Paragard, there is the silver lining related to the environmental effects. The birth controls women take on a daily basis can be excreted into waste water and make their way into the local environments we live in contaminating our water. Studies have shown downstream rocks to be covered in a type of “biofilm” that contains these waste products. So using a copper IUD can actually reduce these waste products from entering our environment to being with.

Copper IUDs are a form of long-acting reversible contraceptives or LARC’s which are recommended by ACOG for prevention of unplanned pregnancy in teens. They are also a form of emergency contraception which can be used with great effectiveness up to 5 days after the unprotected pregnancy encounter.

While IUDs can be an effective and convenient way to control family size, it should be noted that in women delaying childbearing past the age of 30, are at an increased risk for ovarian cancer and birth control pills that are used for 5 consecutive years or more reduces this risk by 50%. This is especially true for ovulation that occurs in the 20s. Therefore, women in their twenties may find the cost-benefit ratio to weigh towards pill use in their 20s switching over to the IUD for the remainder of their family planning years. Also, women that suffer from heavy irregular and/or painful periods may need the pill or a hormone containing IUD to help control their symptoms and to prevent endometrial cancer. Additionally the IUD may be uncomfortable to have placed and does have some risk during or after placement. You can read more about the method here.

Regardless of what my opinions are they are not a medical opinion for individuals and women should always discuss what the right birth control method is for themselves with their own personal physician. For those who do find the Copper T to be the right method for them, they can rest assured knowing that they are doing a little something for conservation of the environment and our water supply.

As a gynecologist, I really value the service that the Environmental Working Group provides for me and my patients. Several years back, they even worked directly with me to create a patient information sheet with how women can reduce their exposure risk to harmful chemicals when women are pregnant, breastfeeding, or trying to conceive. With diseases like Autism Spectrum Disorder and Cancer on the rise, and a poorly regulated chemical industry where harm must be shown before a chemical is taken out of public use, the importance of the work they do cannot be overstated to a public that is often left finding ways to protect itself. In situations like these, grassroots is the only way. This is why I am voluntarily supporting them without their solicitation and hope you will too. They have a great database called Skindeep where you can check out the health risks of the beauty products you use everyday. They also have databases on keeping a healthy home, healthy cleaning products and and sunscreen guide. Having a food database will be that much better for those of us want to know what we are putting into our bodies. After all, you are what you eat.

Here is the patient information they gave me for protecting my pregnant patients as well if you want to use it for yourself or your patients:

The Environmental Working Group

Tips to Reduce Chemical Exposure in Pregnancy

Pollutants in a pregnant woman’s food, air, water or consumer products
can cross the placenta from her body to her child at the most vulnerable time of life. Follow these tips to reduce exposure to harmful chemicals.

Eat Right

Fruits and veggies – Eat plenty of fresh fruits and vegetables. Buy organic when you can to reduce your pesticide consumption. Check out EWG’s Shopper’s Guide to Pesticides in Produce, especially the Dirty Dozen list of high-pesticide fruits and vegetables. http://www.ewg.org/foodnews/

Ditch the can – Choose fresh food over canned, packaged and processed food to avoid bisphenol A, a synthetic estrogen, and other artificial additives and package coatings that can leach into food. Read labels to find foods with natural ingredients and lower sugar, sodium and trans fats.

Safe seafood – Choose low-mercury fish such as salmon, tilapia and pollock, rather than higher-mercury tuna and swordfish. Mercury is a potent neurotoxin that can damage the developing brain and nervous system.

Iodine – Use iodized salt for home cooking. It counters perchlorate and other chemicals that can disrupt the thyroid’s growth hormones critical to a baby’s development.

Storing and cooking – Store food in glass containers. Don’t microwave in plastic, since plastics additives can migrate into your food.
Drink plenty of SAFE water
What’s in your water – Get your water quality report from EWG.org or your local utility. Test your water for lead.
The District of Columbia and Maryland have some of the highest levels of trihalomethanes in the country. This has been linked to miscarriages and birth defects – such as low birth weight, small body length, small head circumference and neural tube defects. This can be removed by using a carbon filter or by boiling your water.
Filtered tap water – Skip bottled water, which costs more and isn’t necessarily better. Filter your tap water instead.

Filter choices – Choose a filter that’s certified to take out your water’s pollutants. Carbon filters are affordable and remove lead and toxic chemicals created by treatment processes at municipal water utilities. Reverse osmosis filters cost more but take out substances that carbon can’t, like arsenic, chromium and perchlorate.

Clothing – Wash maternity clothes before wearing. Clothing is often coated in the factory with chemical treatments.

Green cleaning – Leave shoes at the door to avoid tracking dirt and dust-bound pollutants into your house. Clean with fragrance-free brands. Don’t use unneeded, harsh and caustic products, such as bleach discs for toilet bowls, air fresheners (open a window instead), harsh oven cleaner (use baking soda) or drain cleaners (use a drain snake). Use a wet mop and a HEPA-filter vacuum cleaner to avoid breathing in dust.

remodeling – Avoid remodeling if your house was built before 1978, when lead house paint was banned. Dust from sanding old paint is a common source of lead exposure. If others do the work, make sure they wet-sand chipped areas.

I’ve said it! My favorite bug is L. rhamnosus. I know it sounds crazy, but just looking at the image of them makes me happy. WHY?!

If you haven’t heard the news the bugs, or microbes, that colonize our bodies are amazing. There are over 10,000 strains of these microorganisms that make up almost 5 lbs of our body weight. More and more data continues to emerge related to the bugs that inhabit our bodies and the amazing health benefits they provide, not just for the body, but as it turns out, for the mind as well. We each have our own unique “fingerprint” of these bugs that is likely determined by our mothers vagina, but also, can be influenced by our own diet and lifestyle, and in some cases by taking probiotics. So why do I have a favorite?

For many gynecologists and the women they care for, recurrent BV is a pain in the neck to treat. This is why early in my career, I began to do some research to see how I could better serve my patients. When it comes to recurrent BV, I have had many patients benefit from the simple addition of the strain of Lactobacillus rhamnosus. It turns out that a healthy vaginal flora provides a microenvironment that is not very pleasant for nasty bacteria that can cause a yucky fishy odor and a thin vaginal discharge. This study, published in the journal of Immunology and Medical Microbiology showed that in a randomized, controlled trial, oral L. rhamnosus not only colonized the vagina, it also prevented BV and candida colonization of the vagina. Many of my patients that were coming back to me for recurrent BV swear by this probiotic. Some are even able to treat themselves without the help of antibiotics by taking it when they start to feel some discomfort or discharge.

But wait…there’s another reason why I like this bug for women and it involves weight loss. A large study showed that babies that are delivered by cesarean section and or are formula fed suffer higher rates of adult obesity. It is thought to be due to the lack of healthy flora that babies born through the vagina get. Recently after noticing my own weight gain following treatment with broad spectrum antibiotics, I remembered the studies about obesity and cesarean section. I decided to look into which strains might be beneficial for weight loss. And I found this study. They randomly gave L. rhamnosus or a placebo pill to men and women that were attempting to lose weight with the exact same diet and exercise regimen. They found that the women dieters (BUT NOT THE MEN!!!) using the L. rhamnosus lost twice as much weight as those taking the fake pill. Keep in mind, the study was funded by Nestle so potential bias could exist however the double blind design does minimize potential bias. Keep in mind…you still have to exercise and eat right!!! But the addition of the probiotic should give you an extra boost. It worked for me!

Still more and perhaps most interesting, there was a neurobiology study looking at depression behaviors in in mice taking L. rhamnosus versus not taking it. What they found was that mice that were given the L. rhamnosus (JB-1) strain had significantly lower levels of the stress-induced hormone corticosterone and exhibited less anxiety- and depression-related behavior. It was thought to be driven by the vagus nerve and effects of GABA receptor expression. So how’s that for mind-body. Perhaps we should really be talking about mind-body-bug.

Hopefully this will convince you that your own microbiome can protect you and explains why as a gynecologist, L. rhamnosus is my favorite bug. Here are some natural ways you can promote your body’s own beneficial flora:

Diet high in fiber

Sleep

Exercise

Plant based diet

So there you have it, the reasons why my favorite gut bug is L.rhamnosus.

For more on the microbiome, check out this TEDx Talk on YouTube.

Or this talk by Stanford Immunology Professor David Relman

If you want to try a supplement, here are some products that have the L. rhamnosus strain, but there are many out there that will work, you just have to look for it on the side of the probiotic bottle where they have the strains listed. Try to buy from a reputable company however so you can ensure you are getting active strains.

With all of the varied diets that are promoted all over the place, what’s a woman that wants to stay healthy to do?

So by now, most of us know we shouldn’t “diet”. It is really about making healthy food choices that become a part of our everyday life and habits. Does that mean you can’t sneak a sweet treat every now and again? ABSOLUTELY NOT. But if you do, be sure to fully indulge. Here is a great posting on NPR from yesterday. When folks were given the same exact 300 calorie delicious milkshake, one was labeled low calorie, fat free, and guilt free, while the other was labeled with exactly what it was, 300 calories. Well what happened next was yet another window into the mind body connection and the miriad of ways that what we believe can actually affect how our body responds the food we put into our bodies! The folks that drank the mislabeled “healthy milkshake” secreted more Ghrelin. This hormone basically makes you think you are hungry and leads you to seek out more “satisfying foods”. But wait…there’s more, it also slows your metabolism, making it harder to burn calories and easier to gain fat and store sugars.

WHAT!!!!

So what does this mean? It means, fully enjoy in your food. Eat mindfully and indulge in your food. Even if it is healthy food. When you are mindfully eating, enjoying your food and the way it is nourishing your body, your mind is sending out all the right hormones to satisfy your hunger. If on the other hand, you are restricting your diet with health foods you really don’t want, you may actually be shooting yourself in the foot.

You can try mindful eating on your own the next time you eat. If you have a grape handy, it is always fun to try with that. Take a quiet moment to savor a grape in a way you never have. Slow down. Pick up the grape. Feel it in your fingers, note how it feels or any thoughts you may be having about eating the grape. Place the grape in your mouth. Notice any sensations on your tongue. Slowly bite into the grape and feel the texture, the pressure on your teeth. Feels the juicy sweetness that bursts onto your tongue as you bite into the grape. Take your time as you savor the flavors and aromas. Notice how you feel while you are eating the grape. Note: You can try this with any food.

Want to try a free webinar on mindful eating? Check out the Center for Mindful Eating. They have a webinar coming up on April 24, 2014. For further reading, check out a NY Times article on mindful eating to avoid binging here.